Bendifallah Sofiane, Ballester Marcos, Daraï Emile
Université Pierre-et-Marie-Curie Paris 6, AP-HP, hôpital Tenon, service de gynécologie obstétrique et médecine de la reproduction, 4, rue de la Chine, 75020 Paris, France.
Université Pierre-et-Marie-Curie Paris 6, AP-HP, hôpital Tenon, service de gynécologie obstétrique et médecine de la reproduction, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, Inserm UMR S 938, France.
Bull Cancer. 2017 Dec;104(12):1022-1031. doi: 10.1016/j.bulcan.2017.06.017. Epub 2017 Oct 27.
In France, in 2015, endometrial cancer (CE) is the first gynecological cancer in terms of incidence and the fourth cause of cancer of the woman. About 8151 new cases and nearly 2179 deaths have been reported. Treatments (surgery, external radiotherapy, brachytherapy and chemotherapy) are currently delivered on the basis of an estimation of the recurrence risk, an estimation of lymph node metastasis or an estimate of survival probability. This risk is determined on the basis of prognostic factors (clinical, histological, imaging, biological) taken alone or grouped together in the form of classification systems, which are currently insufficient to account for the evolutionary and prognostic heterogeneity of endometrial cancer. For endometrial cancer, the concept of mathematical modeling and its application to prediction have developed in recent years. These biomathematical tools have opened a new era of care oriented towards the promotion of targeted therapies and personalized treatments. Many predictive models have been published to estimate the risk of recurrence and lymph node metastasis, but a tiny fraction of them is sufficiently relevant and of clinical utility. The optimization tracks are multiple and varied, suggesting the possibility in the near future of a place for these mathematical models. The development of high-throughput genomics is likely to offer a more detailed molecular characterization of the disease and its heterogeneity.
2015年在法国，子宫内膜癌（CE）在发病率方面是第一大妇科癌症，是女性癌症的第四大病因。据报告，新发病例约8151例，死亡近2179例。目前的治疗方法（手术、体外放疗、近距离放疗和化疗）是基于复发风险评估、淋巴结转移评估或生存概率评估来实施的。这种风险是根据单独的或组合成分类系统形式的预后因素（临床、组织学、影像学、生物学）来确定的，而目前这些因素不足以解释子宫内膜癌的演变和预后异质性。近年来，针对子宫内膜癌，数学建模的概念及其在预测中的应用得到了发展。这些生物数学工具开启了一个以促进靶向治疗和个性化治疗为导向的护理新时代。已经发表了许多预测模型来估计复发风险和淋巴结转移风险，但其中只有极小一部分具有足够的相关性和临床实用性。优化途径多种多样，这表明在不久的将来这些数学模型有可能占有一席之地。高通量基因组学的发展可能会对该疾病及其异质性提供更详细的分子特征描述。
